Comparison of the Effects of Magnetically Controlled Growing Rod and Tradiotinal Growing Rod Techniques on the Sagittal Plane in the Treatment of Early-Onset Scoliosis

Abstract

Objective Comparing the effects of magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) techniques on the sagittal plane in the treatment of early-onset scoliosis (EOS). Methods Twelve patients were operated using dual MCGR technique in one center, while 15 patients were operated using dual TGR technique for EOS in another center. Patients’ demographic characteristics, complications and radiological measurements such as cobb angle, thoracic kyphosis, lumbar lordosis, T1–S1 range (mm), proximal junctional angle, distal junctional angle, sagittal balance, coronal balance, pelvic incidence, sacral slope and pelvic tilt were assessed and compared in preoperative, postoperative and last follow-up period. Results Age and sex distributions were similar in both groups. The mean number of lengthening in the MCGR group was 12 (8–15) and 4.8 (3–7) in the TGR group. Two techniques were shown to be effective in controlling the curvature and in the increase of T1–S1 distance. In TGR group, four patients had rod fractures, six patients had screw pull-out and four patients had an infection, whereas three patients had screw pull-out and one patient had infection complications in the MCGR group. Conclusion There was no significant difference between the two groups in terms of cobb angle, coronal and sagittal balance and sagittal pelvic parameters. MCGR can cause hypokyphosis and proximal junctional kyphosis in a minimum 2-year follow-up period. The implant-related complications were less in the MCGR group. However, larger case groups and longer follow-up periods are required for the better understanding of the superiority of one method on other in terms of complications.

<p>Magnetic Controlled Growth Rods in the Treatment of Scoliosis: Safety, Efficacy and Patient Selection</p>

“…There are few studies comparing outcomes between TGRs and MAGEC for EOS; 2 studies comparing the thoracic and total spinal height growth between TGRs and MAGEC have reported no significant difference between groups. 61,64 Cohort studies have highlighted that MAGEC does not control thoracic kyphosis and may lead to proximal junctional kyphosis and failure of proximal implant fixation. 37,64 This is a complication not dissimilar to TGRs as a posteriorly based construct has a kyphogenic effect precipitated by serial rod lengthenings and driving the upper thoracic spine into junctional kyphosis resulting in proximal anchor failure.…”

“…61,64 Cohort studies have highlighted that MAGEC does not control thoracic kyphosis and may lead to proximal junctional kyphosis and failure of proximal implant fixation. 37,64 This is a complication not dissimilar to TGRs as a posteriorly based construct has a kyphogenic effect precipitated by serial rod lengthenings and driving the upper thoracic spine into junctional kyphosis resulting in proximal anchor failure. Loss of distraction can occur with MAGEC, which is also associated with a high rate of revision surgery for implant failure.…”

A biomechanical study on the effect of lengthening magnitude on spine off-loading in magnetically controlled growing rod surgery: Implications on lengthening frequency

“…6 The clinical efficacy of MCGR has been demonstrated to be equally effective as TGR with the added benefit of non-invasive distractions. [7][8][9][10][11][12] Recent long-term results report consistent spine and rod lengthening throughout growth while providing additional advantages to spine length gain over TGR by avoiding autofusion of the spine associated with forceful surgical distractions at irregular intervals. 13,14 Despite these advantages, complications remain common, with up to 46.7% of patients requiring an unplanned operation at 2-year follow-up.…”

A comparison of the post-fusion outcome of patients with early-onset scoliosis treated with traditional and magnetically controlled growing rods

“…Althoughnationalregistriesandsurveydataprovideuseful insights,comparingtheoutcomesofthetwodeviceshasproved challenging,withconflictingresults,becauseofthecomplexity andheterogeneityofpatientswithEOS.Overthepastdecade, various centres around the world have reported the results of theirexperience. [15][16][17] Thereexists,however,awidevariationin the choice of measured outcomes.…”